| NPI | 1568563435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CT 034638) |
| Additional Taxonomies | 202C00000X Independent Medical Examiner (Licence: CT 034638) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CT 064638) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2008-03-24 |